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NPI Code Detail

MEDICARE: SMILE STOP P.C.

MEDICARE: SMILE STOP P.C.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1302F00000XExclusive Provider Organization23141TX

General Provider Information

NPI Number : 1932490893
Entity Type Code : Organization
Provider Name (Legal Business Name) : SMILE STOP P.C.
Provider Business Mailing Address
First Line : 820 S FRIENDSWOOD DR STE 102
Second Line :
City : FRIENDSWOOD
State : TX
Zip : 77546-4543
Country : US
Telephone Number : 281-482-2640
Fax Number : 281-482-0545
Provider Business Practice Location Address
First Line : 820 S FRIENDSWOOD DR STE 102
Second Line :
City : FRIENDSWOOD
State : TX
Zip : 77546-4543
Country : US
Telephone Number : 281-482-2640
Fax Number : 281-482-0545
Authorized Official
Title or Position : ORTHODONTIST
Name : GERARDO GUAJARDO GUAJARDO
Credential : D.D.S., M.S.D.
Telephone Number : 281-482-2640
Provider Enumeration Date : 04/27/2011
Last Update Date : 04/27/2011

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Directions to “SMILE STOP P.C. ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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